Use of Direct Peritoneal Resuscitation for Intra-Abdominal Catastrophes: A Technical Note

Direct peritoneal resuscitation (DPR) involves instilling 2.5% dextrose peritoneal dialysate into the abdomen in an attempt to both resuscitate the patient and decrease systemic inflammation; 800cc are instilled in the first hour and 400cc/h are instilled each subsequent hour. DPR has been shown to decrease systemic inflammation, increase the rate of primary abdominal closure, lower the rate of intra-abdominal infections, and lower the rate of complications. It also increases blood flow to the intestines, helping to prevent ischemia and re-perfusion injury. We present the technique used for DPR in a patient with an intra-abdominal catastrophe, as well as the use of Kerecis® Omega3 Wound graft (Kerecis, Arlington, VA) and wound vacuum-assisted closure (VAC) for creation of a floating stoma.